Doctor Name: | KELVIN MALONE |
NPI Number: | 1144690595 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 005199747 |
Business Practice Address: | 1610 Shively Rd Saline, LA - 710702355 |
Business Phone Number: | 3185832892 |
Business Fax Number: | |
Mailing Address: | 1610 Shively Rd, SALINE |
State: | LA |
Postal Code: | 710702355 |
Phone Number: | 3185832892 |
Fax Number: | |
NPI Enumeration Date: | 09/28/2015 |
NPI Last Update Date: | 09/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 172A00000X |
License Number: | 005199747 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Driver |
Taxonomy Specialization: | |
Taxonomy Definition: | A person employed to operate a motor vehicle as a carrier of persons or property. |